A prescribing incentive scheme for non-fundholding general practices: an observational study

Area of Science:

• Health Economics
• General Practice
• Pharmaceutical Policy

Background:

• Financial incentive schemes are increasingly used to influence healthcare provider behavior.
• Understanding the impact on prescribing patterns in general practices is crucial for cost-effective healthcare delivery.

Purpose of the Study:

• To evaluate the effect of a financial incentive program on the prescribing practices of non-fundholding general practices.
• To assess whether financial incentives impact prescribing quality and overall expenditure.

Main Methods:

• An observational study involving 459 non-fundholding general practices in the former Northern region (1993-4).
• Practices were grouped by prescribing expenditure relative to the local average.
• Incentives were offered for achieving set savings targets, with outcomes measured against financial performance, prescribing patterns, generic prescribing rates, and prescribing quality.

Main Results:

• 23% of practices achieved their savings targets, with higher achievement rates in lower-expenditure groups.
• Practices meeting targets showed reduced prescribing frequency for specific drug classes (gastrointestinal, inhaled steroids, antidepressants, HRT) but no decline in prescribing quality.
• Total savings of £1.54 million were realized, with £463,000 returned to practices for primary care investment.

Conclusions:

• Non-fundholding general practitioners' prescribing behavior is responsive to financial incentives, mirroring findings in fundholding practices.
• The implemented incentive scheme successfully reduced prescribing costs without negatively affecting the quality of care provided.